Diabetes

[ShoppGirl 3,340]

Okay I have been gaining weight post sleeve so I asked my family dr about my hormones. He ordered some thyroid labs but says he also wants me to come get my blood sugar checked two hours after a big meal. He also said that my psyc meds can cause diabetes and I should be doing this test every 4-6 months as long as I’m on them. i thought he was suggesting this as a possibility for why I’m gaining weight but when I got home and googled it I see that weight loss is actually a symptom so I am confused. I drink about a gallon a day so I guess I may check the excessive thirst box and of course I pee a lot with all that Water. Also, did tell him that I always feel hungry but I’m gaining not losing. Am I misunderstanding. I know nothing about diabetes.

[SpartanMaker 676]

Oh how nice it would be if diabetes made you lose weight!

People with diabetes don't respond correctly to insulin. The main job of insulin is to signal your cells to take up the sugar in your blood to use as fuel. Because that process isn't working like it should, people with diabetes have excess sugar in their blood. That excess blood sugar has to go somewhere. Where it goes is that your body converts it into fat and stores it.

There's a reason why type 2 diabetes is strongly correlated with obesity. Being overweight can lead to insulin resistance on a cellular level, which can lead to more weight gain, which makes your body unable to as efficiently process the insulin, which can lead to more weight gain, and so on.

Now just like any other potential hormonal imbalance, being diabetic does not make you gain weight. It just means that all other things being equal, it's more likely. To gain weight, you still have to eat more than you burn, regardless of any hormone issues.

[ShoppGirl 3,340]

36 minutes ago, SpartanMaker said:

Oh how nice it would be if diabetes made you lose weight!

People with diabetes don't respond correctly to insulin. The main job of insulin is to signal your cells to take up the sugar in your blood to use as fuel. Because that process isn't working like it should, people with diabetes have excess sugar in their blood. That excess blood sugar has to go somewhere. Where it goes is that your body converts it into fat and stores it.

There's a reason why type 2 diabetes is strongly correlated with obesity. Being overweight can lead to insulin resistance on a cellular level, which can lead to more weight gain, which makes your body unable to as efficiently process the insulin, which can lead to more weight gain, and so on.

Now just like any other potential hormonal imbalance, being diabetic does not make you gain weight. It just means that all other things being equal, it's more likely. To gain weight, you still have to eat more than you burn, regardless of any hormone issues.

Hummmm. I gotta do more research. I swear I just read that it causes weight LOSS which didn’t make sense at all since so many people have WLS because of diabetes and he was ordering the test for ME.

[SpartanMaker 676]

Just now, ShoppGirl said:

Hummmm. I gotta do more research. I swear I just read that it causes weight LOSS which didn’t make sense at all since so many people have WLS because of diabetes and he was ordering the test for ME.

I think the things you read may be referring to type 1 diabetes? For type 1, your body produces little to no insulin instead of too much. Because there's no insulin there to signal your body to take up the sugar, your body instead starts to breaks down muscle and fat for energy, which would lead to sudden, unexplained weight loss.

While type 1 is a remote possibility, it's a lot more likely your doctor is concerned about type 2. Type 1 used to be called juvenile onset diabetes because that's normally when it's discovered. It can also start in adults, but not very often. Type 2 used to be called adult onset, because that was historically when it would be seen. Now with obesity at epidemic proportions, even children sometimes get type 2.

[ShoppGirl 3,340]

Does anyone else’s doctor do the glucose test two hours after a “big meal”. I am supposed to do this this week sometime and he said instead of drinking the sugar drink I can have a big meal. Since I can’t eat a big volume I assume something with a lot of calories? I was thinking of a bacon cheeseburger with avocado and ranch would be really heavy even if I only eat like half. Do I need to have actual sugar though? I tried to google it but I think my dr may be a bit old school cause I couldn’t find anyone else who does the test this way.

[SpartanMaker 676]

3 hours ago, ShoppGirl said:

Does anyone else’s doctor do the glucose test two hours after a “big meal”. I am supposed to do this this week sometime and he said instead of drinking the sugar drink I can have a big meal. Since I can’t eat a big volume I assume something with a lot of calories? I was thinking of a bacon cheeseburger with avocado and ranch would be really heavy even if I only eat like half. Do I need to have actual sugar though? I tried to google it but I think my dr may be a bit old school cause I couldn’t find anyone else who does the test this way.

I've never had to do anything like that and never heard of doctors doing such a thing?

Here's are a couple of basic rundowns of types of blood sugar tests:

https://www.cdc.gov/diabetes/basics/getting-tested.html

https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis

Honestly, the A1C is probably most used, along with a fasting glucose test. (FYI, clinical standards typically require at least 2 different tests, or 2 readings of the same test separated by time, before a positive diagnosis of diabetes should be made.) Both of these tests are easy to do, since they can be part of a regular blood draw. Some docs also like to see a glucose tolerance test, because this will show the swings in your blood sugar the others won't. For example, A1C is an average, but just like 5 is the average of 4 and 6, it's also the average of 1 and 9. Knowing just how big those swings are may help with a treatment plan. I doubt many do that up front, though. Typically they.ll do the A1C and fasting blood glucose and then decide if additional testing is needed.

The problem with what your doctor is proposing is that it's not standardized. As you hinted at, your blood sugar levels could be different if you ate a carb heavy meal vs. a Protein heavy meal. Without a way to control or account for that, I personally can't see the value in this non-standard test.

[ShoppGirl 3,340]

1 hour ago, SpartanMaker said:

I've never had to do anything like that and never heard of doctors doing such a thing?

Here's are a couple of basic rundowns of types of blood sugar tests:

https://www.cdc.gov/diabetes/basics/getting-tested.html

https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis

Honestly, the A1C is probably most used, along with a fasting glucose test. (FYI, clinical standards typically require at least 2 different tests, or 2 readings of the same test separated by time, before a positive diagnosis of diabetes should be made.) Both of these tests are easy to do, since they can be part of a regular blood draw. Some docs also like to see a glucose tolerance test, because this will show the swings in your blood sugar the others won't. For example, A1C is an average, but just like 5 is the average of 4 and 6, it's also the average of 1 and 9. Knowing just how big those swings are may help with a treatment plan. I doubt many do that up front, though. Typically they.ll do the A1C and fasting blood glucose and then decide if additional testing is needed.

The problem with what your doctor is proposing is that it's not standardized. As you hinted at, your blood sugar levels could be different if you ate a carb heavy meal vs. a Protein heavy meal. Without a way to control or account for that, I personally can't see the value in this non-standard test.

Well the fasting glucose is the one that’s a part of the regular labs, right? I get those Wednesday. My last one was right on the upper cusp of normal when I looked back but idk if he seen that or not. I think this Is his version of a glucose tolerance or glucose challenge test??. I say that just because he said I can just eat a big meal instead of drinking the gross drink. But it’s not a blood test (it’s the finger prick one) so idk. Lol

Edited October 31, 2022 by ShoppGirl

[ShoppGirl 3,340]

Accidental post

Edited October 31, 2022 by ShoppGirl

[LookingForward22 320]

I don’t have a diabetes diagnosis at this point (hoping to avoid that) but I was diagnosed with metabolic resistance and was on my way towards a diabetes diagnosis prior to weight loss surgery.

Metabolic resistance can cause your body to react in different ways and really make loosing weight difficult - even when you are doing everything right. It’s a combination of several medical conditions that affect how your body breaks down and processes insulin.

I struggled having to eat less than a 900 calories (prior to WLS) to see any results along with exercise (it was not maintainable long term). Eventually I agreed to try some medication - which made all the difference, I was finally able to eat reasonably and loose weight (slowly) but I was loosing.

My body still fights me - but it’s better. I’m hoping the damage that metabolic syndrome can cause is reversible for me - depends on several factors (like how much damage was done while it was active, if my weight was the cause or genetics).

The tests I’ve had are the fasting glucose & A1C, I’ve had non fasting test (but not asked to eat anything specific) and I’ve had to drink the sugary drink (which is awful).

A family Dr is a good place to start, but I’d suggest talking with an endocrinologist if you don’t have one you see. Mine has been a blessing helping me dial in things and he doesn’t solely rely on labs to do it. He looks at my labs and my symptoms to make adjustments… in addition to metabolic syndrome - I have Hashimoto’s also. While ranges are great to guide you if you are looking for something wrong. My Endo is the first to say “that may not be what’s normal for you, so let’s see if we can do better”.

Since my WLS I’ve had improved numbers across the board, except my cholesterol, but that might stay high till my weight stabilizes. I still have to take a medication to help my body process the insulin and when I take it, the weight comes off slowly but more easily than when I don’t. (Even if I am eating all the same things and doing the same activity).

As far as what to eat, I would think the dr wants to see how your body is processing carbs in your normal diet, if they didn’t give you specific guidelines on what to eat. My guess on the “big meal” is they don’t want you to eat minimally and the test results wouldn’t be as accurate. Depending on the results - it might dictate the next test(s). So I would eat whatever the normal diet is I was eating (and struggling with) to give an accurate reflection of how my body is handling the breakdown, not cutting out carbs or anything else (dessert or snacks) that I would normally have.

Good luck!

[ShoppGirl 3,340]

5 hours ago, LookingForward22 said:

I don’t have a diabetes diagnosis at this point (hoping to avoid that) but I was diagnosed with metabolic resistance and was on my way towards a diabetes diagnosis prior to weight loss surgery.

Metabolic resistance can cause your body to react in different ways and really make loosing weight difficult - even when you are doing everything right. It’s a combination of several medical conditions that affect how your body breaks down and processes insulin.

I struggled having to eat less than a 900 calories (prior to WLS) to see any results along with exercise (it was not maintainable long term). Eventually I agreed to try some medication - which made all the difference, I was finally able to eat reasonably and loose weight (slowly) but I was loosing.

My body still fights me - but it’s better. I’m hoping the damage that metabolic syndrome can cause is reversible for me - depends on several factors (like how much damage was done while it was active, if my weight was the cause or genetics).

The tests I’ve had are the fasting glucose & A1C, I’ve had non fasting test (but not asked to eat anything specific) and I’ve had to drink the sugary drink (which is awful).

A family Dr is a good place to start, but I’d suggest talking with an endocrinologist if you don’t have one you see. Mine has been a blessing helping me dial in things and he doesn’t solely rely on labs to do it. He looks at my labs and my symptoms to make adjustments… in addition to metabolic syndrome - I have Hashimoto’s also. While ranges are great to guide you if you are looking for something wrong. My Endo is the first to say “that may not be what’s normal for you, so let’s see if we can do better”.

Since my WLS I’ve had improved numbers across the board, except my cholesterol, but that might stay high till my weight stabilizes. I still have to take a medication to help my body process the insulin and when I take it, the weight comes off slowly but more easily than when I don’t. (Even if I am eating all the same things and doing the same activity).

As far as what to eat, I would think the dr wants to see how your body is processing carbs in your normal diet, if they didn’t give you specific guidelines on what to eat. My guess on the “big meal” is they don’t want you to eat minimally and the test results wouldn’t be as accurate. Depending on the results - it might dictate the next test(s). So I would eat whatever the normal diet is I was eating (and struggling with) to give an accurate reflection of how my body is handling the breakdown, not cutting out carbs or anything else (dessert or snacks) that I would normally have.

Good luck!

My family dr is running some labs on my thyroid as well but I am thinking if nothing comes up from any of this that I am going to see an endocrinologist just in case it is something that isn’t cookie cutter for family practice to pick up. I just wish i had explored these things a little more before WLS. I hope I haven’t blown my one chance at it because I seem to be doing things backwards.

[LookingForward22 320]

On 10/31/2022 at 18:14, ShoppGirl said:

My family dr is running some labs on my thyroid as well but I am thinking if nothing comes up from any of this that I am going to see an endocrinologist just in case it is something that isn’t cookie cutter for family practice to pick up. I just wish i had explored these things a little more before WLS. I hope I haven’t blown my one chance at it because I seem to be doing things backwards.

I understand your concern - took me years to get my endocrine issues diagnosed because I wasn’t cookie cutter either.

My endocrinologist is amazing working with my weight, thyroid and other issues. Find a good one and I would bet they can be supportive and helpful - even if it’s not 100% fixed.

Take one breath at a time and I can’t imagine you’ve blown your chance - at worst let’s hope this is just a side step and you will soon be back on track.

Let us know how things are going. My progress has been slow and tedious, but between the looooong stalls - I am still making baby steps forward I’m getting there. You will too!!!

[ShoppGirl 3,340]

2 minutes ago, LookingForward22 said:

I understand your concern - took me years to get my endocrine issues diagnosed because I wasn’t cookie cutter either.

My endocrinologist is amazing working with my weight, thyroid and other issues. Find a good one and I would bet they can be supportive and helpful - even if it’s not 100% fixed.

Take one breath at a time and I can’t imagine you’ve blown your chance - at worst let’s hope this is just a side step and you will soon be back on track.

Let us know how things are going. My progress has been slow and tedious, but between the looooong stalls - I am still making baby steps forward I’m getting there. You will too!!!

Thanks!!

[ShoppGirl 3,340]

Well I actually did a lot of research and it turns out it doesn’t matter when the dr checks your levels, if it’s over 200 you are diabetic whether you have eaten anything or not. It’s a random test and it’s listed on that CDC link you sent me spartanmaker. (And Thank you for that by the way it was very helpful). I did the test today and they said he was looking to see if it was over 140 though which would point to the possibility of pre diabetes but it wasn’t even close. It was 114 after eating worse than I have since my surgery so I’m definitely not diabetic.

I also did my labs this morning which included three thyroid tests so maybe something will come of that. If not, I did ask him for a referral to an endocrinologist to make absolutely sure nothing has been missed. He said if my thyroid labs are good he would be inclined to agree with the surgeons that is my bipolar meds making me eat more but seeing an endocrinologist couldn’t hurt for my peace of mind.

I have to admit when she gave me the very positive results that I am not diabetic I felt a little let down just for a second. Of course I don’t want a diabetes diagnosis but I AM very much desperate for an answer. Some answer. It’s just so darn frustrating. I just feel like such a failure that I went through with this huge invasive surgery and I am gaining it back. I think I am most annoyed with myself for not asking more questions and pursuing more tests BEFORE I did surgery. I guess what’s done is done though and I just gotta keep trying. I did lose two pounds before my big high calorie meal today. That’s something I guess. Lol

[LookingForward22 320]

@ShoppGirl - I understand your frustration, but hang in there. No one wants diabetes, but some answers would be nice.

My Thyroid showed fine for several tests and across multiple years, but it wasn’t working properly. Also my body wasn’t processing insulin efficiently - but it wasn’t consistent. Sometimes it worked ok (my numbers/labs were fine) sometimes it didn’t. I don’t have a diabetes diagnosis, but I do have an insulin resistance / Metabolic Syndrome dx.

I’m glad you are going to follow up with an Endo just for clarification. Hopefully they can help you look at what might be going on and either find some answers or help treat some of symptoms you have, lessening the overall impact.

I’ve been where you are and it isn’t fun. I hope that you are able to get some answers and make some progress soon. It’s very frustrating when our body’s are fighting against us, despite our best efforts.

Hang in there, you’ve got this. If you need to chat or anything DM me. Keep up the good work, you can do this!

[ShoppGirl 3,340]

2 hours ago, LookingForward22 said:

@ShoppGirl - I understand your frustration, but hang in there. No one wants diabetes, but some answers would be nice.

My Thyroid showed fine for several tests and across multiple years, but it wasn’t working properly. Also my body wasn’t processing insulin efficiently - but it wasn’t consistent. Sometimes it worked ok (my numbers/labs were fine) sometimes it didn’t. I don’t have a diabetes diagnosis, but I do have an insulin resistance / Metabolic Syndrome dx.

I’m glad you are going to follow up with an Endo just for clarification. Hopefully they can help you look at what might be going on and either find some answers or help treat some of symptoms you have, lessening the overall impact.

I’ve been where you are and it isn’t fun. I hope that you are able to get some answers and make some progress soon. It’s very frustrating when our body’s are fighting against us, despite our best efforts.

Hang in there, you’ve got this. If you need to chat or anything DM me. Keep up the good work, you can do this!

Thanks!!